Food Service and the Dietitian

In non-rock band-related topics: can you believe at this time last year, I was in China? Time flies when you’re learning how to be a dietitian! To relive my China adventures, live scorpions and all, click here.

In non-rock and non-China-related topics: I have just completed my penultimate dietetic internship rotation in food service at Jefferson House, a long-term care and rehabilitation facility in Connecticut. Remember my previous posts about what a dietitian does? In this post, I’ll chat a little about what a food service dietitian in a health care setting might do. First, let’s go inside Jefferson House!

Bill oversees both the kitchen staff and the clinical dietitians at Jefferson House, creating one efficient team that works well together. Part of his success as department director, I believe, is his ability to step into any role required of him: in one day, I’ve seen him both attend a food contract meeting with department heads from other hospitals and unload four pallets worth of groceries into the facility’s storeroom (I tried to help and spent most of my time either struggling to lift relatively light boxes or standing in the middle of the room, asking “Where does this go?” Yeah, I think you were more of a hindrance, Jessie. Also, I need to work on my T-rexarms.)

Bill happily explained his many daily tasks, including ordering food and supplies based on inventory, figuring out the department budget, discussing new food products with sales representatives, reading about the food service industry’s latest news (including changing food prices), reviewing current menus for possible changes, researching new equipment purchases, evaluating the draft contract for an upcoming food contract, reviewing bills and expenses, etc., just to name a few! In addition, Bill operates a catering business that serves both Jefferson House residents/employees and outside groups. To be able to manage all these tasks, one needs to be organized and efficient – Bill certainly has both these qualities in spades! Although Bill is not a dietitian himself, dietitians often hold similar positions. If you’ve been reading my dietitian series, you’ll know that dietitians have many diverse jobs!

Enough text … more pictures! Let’s enter the kitchen:

Hi, Joe!

I don’t have any pictures of me at a computer this time, because, with the exception of a few projects, I spent most of my time on my feet and in the kitchen learning how a large kitchen operates. An enormous THANK YOU to all the wonderful women and men who work in the Jefferson House kitchen who welcomed me into the facility! You were a huge part of why I had such a great time over the past four weeks 🙂

While working in the kitchen, I learned how food production is carefully timed and organized so that meals reach the residents on time and piping hot (or cold, as the case may be). Everyone has their own job that must be completed by a certain time. People who have not worked in a large-scale kitchen may not realize how much work goes on behind the scenes – I can tell you, it takes a LOT of work to serve those meals.

Here, I have just finished setting up these trays:

And toasting bread for “breakfast club”, a special breakfast the kitchen cooks for the residents once a month:

Obviously, I still need to work on my aim when taking pictures of myself.

When working in a long-term care facility, you often need to think about older residents who may either not be eating enough or have chewing or swallowing difficulties. Nutrition supplements to the rescue! I had a chance to finally see some of the nutritional supplements that I had only heard about, including this little gem:

This ice cream-like item is a Magic Cup, a high calorie, high protein supplement for people with swallowing disorders. Often, someone who has difficulty swallowing (due to neurological or physical problems) cannot swallow thin liquids. Even though Magic Cup has the consistency of ice cream when frozen, it doesn’t melt into a thin liquid like regular ice cream does – that could be dangerous for someone with swallowing difficulties. Instead, it softens to a pudding-like consistency.

Like many specialized nutritional supplements, Magic Cup is expensive, so I made sure to get permission from Bill before trying one (thanks, Bill!). I chose the chocolate flavor (of course).

The frozen version tastes almost like chocolate ice cream. I could taste a little “extra”, likely from the additional supplements in this product. When melted, the Magic Cup looks like this:

… and, tastes just like chocolate pudding! Mmm. I can imagine that someone who is not eating well and has difficulty swallowing would enjoy a Magic Cup.

Another product for people with swallowing difficulties is pre-thickened water and juice:

I tried the thickened water, and guys: it is bizarre drinking thickened water. WATER.

Enlive, a clear liquid supplement for people who are recovering from surgery or who currently can’t handle regular food or liquids:

Similarly, jello packed with protein:

Finally, for residents with oral problems including chewing difficulties, pureed food is available. I love how these pre-pureed foods are reformed in the shape of the actual food. For example, corn:

Pureed turkey, with meal tallies in the background:

A few other images from my time at Jefferson House:

Pretending to flip burgers for one of the residents’ cookouts:

Womanning the table at one of Bill’s catering events:

One of my projects during this internship was finding the kitchen a new frialator (I kid you not). Here, I’m standing next to the current fryer:

On my last day, everyone in the kitchen threw me a party:

I’ll admit to you, my dear reader: I got a bit teary when I saw this spread. Ladies and gentlemen of Jefferson House, I will miss you tremendously.

So, there you have it, folks! Dietetics and food service in a health care setting – varied and never boring!

Now, I only have ONE two-week rotation left in my dietetics internship! I can’t believe I’m almost done. For my final rotation, I will be working with Lanette Kovachi, Subway‘s corporate dietitian. I’m looking forward to it!

Have a wonderful week, everyone! 😀

Q: Have you ever worked in a large-scale kitchen? What do you think about those nutritional supplements? Before studying dietetics, I never knew there was a need for these modified food supplements!

Comments

Ugh Magic Cup.
When my dad was in the hospital the patients got an orange flavoured Magic Cup as a snack. It was thoroughly disgusting in taste, texture, and flavour. And how can it possibly be healthy?

You bring up a really good point, Samantha. I can’t attest to the taste of the orange flavor (although apparently it could use some work!), but I should mention that the Magic Cup is not meant to be an all-natural, healthy snack – besides its function as a supplement for people with swallowing difficulties, Magic Cup is also a high calorie, (especially) high protein supplement for people who aren’t eating well or who need extra protein to aid healing (often the case in a hospital). It’s definitely not a “natural” product when they’re just trying to get as many calories and as much protein as possible into someone 🙂

The only time I heard of supplements was when this distant relative who had Alzheimer’s disease stopped eating and drinking altogether, and they would rub a special water gel on her arms and legs which was her only source of hydration. Sad story 🙁

Jessie I don’t know if I have asked before, but how do you arrange all these rotations? Does your uni help you or do you have to make contacts all alone?

And no I have never worked in a large-scale kitchen, but I’m sure it must be very difficult, that’s why you have to study in order to be able to work there I guess!! If you want to do the job well that is…

I’m very lucky to be in a program where my uni arranges nearly all of my rotations! This spring, we gave preferences for where we would like to go, and then our uni contacted places for us. The only one I found on my own is Subway, but even then my uni helped me arrange it. Makes things easier for us! 🙂

Oh Jessie, you look and seem so happy interning there. I wish I was that happy at work 🙁 Speaking of work, I have no motivation to go to work these days but it pays the bills so I can’t complain that. Anyway, the tasks and products at Jefferson House sound healthy and very interesting!

I’ve never worked in a large scale kitchen but I totally take your word for it that there’s a lot to do. My uncle owns 2 restaurants and watching him manage just one is exhausting.

Those food supplements are so cool. Makes so much sense that the magic cup does just melt away like ice cream. Whoever thought of that was genius. And the prepureed foods shaped into other stuff is too cute. It’s almost like Chinese vegetarian food being made to imitate duck or fish, etc. That thickened water sound a bit weird though. Not sure if I’d enjoy drinking it.

That is too sweet that the kitchen staff threw you a goodbye party! I would totally tear up too, Jessie. Actually I might start bawling. Lol. I reared up reading this. Haha. I’m not surprised they threw you a party though. I can definitely tell just by keeping in contact with you that you’re one of those people that everyone falls in love with just by talking to you for a while. I’m so happy for you that you seem to be having such a great time and learning experiences with your internships. Subway sounds like a fun one! K was just introduced to subway a couple weeks ago and she loves it. Everytime we drive by a Subway sign, she has to point it out to me, almost in a hinting manner. Lol. Well, wish you luck with your last intern placement and have lots of fun. ALMOST FINISHED, WOOT!

Wow Jessie! You’ve had so many interesting adventures, and each one seems to be quite different. I love reading about it all and seeing your photos 🙂 Soon you’ll be finished! I’m really curious to find out what kind of place you’ll choose to work at.

I used to work at a supplement store and I definitely preferred the natural supplements that were closer to whole foods rather than the synthetic mystery stuff. However, those were tonics and capsules for the most part…I can’t think of anything natural that resembles the magic cup for example. It must be really hard to meet those special needs while also providing good, wholesome nutrition.

Have a wonderful week Jessie! It’s always so good to see a new post of yours! 🙂

Wow this was so interesting! I am definitely all for these types of nutritional supplements. My father was very sick several years ago and if it weren’t for meal replacements like Ensure he never would’ve gotten the calories he needed! It’s not ideal, but in circumstances like that, I’m glad they have them!

I’m so glad you enjoyed your time at the Jefferson House so much! Sounds like you learned so much and got to work with some amazing people. Thanks for the info on those nutritional products, they sound really interesting…I’d definitely be interested in trying a Magic Cup! 🙂

I have never seen those magic cups. I do remember thickened liquids. Oh gosh, some of that hospital food!!! I really remember learning so much from the food service rotation. It really helps getting hands on in that area as well.
Thanks for sharing Jessie!

That is eye-opening experience!!! I have never heard of so many interesting food , especially those thickened water,and the pre-pureed corn. I guess they are really helpful. Thanks for sharing your story, Jessie! Have a great week!

Jessie, I love reading about your rotations! You should definitely advertise this series of blog posts, for future RD interns. I would have really found these post helpful before my internship.

I used to have a huge interest in being a food service RD. I really respect and admire food service dietitians. If I ever change careers, I would love to work in a hospital or especially a school kitchen.

I can’t wait to read about your week with the Subway RD! Wow, what an experience that’s going to be. I’ll best she had something to do with the avocados they are now serving. Brillian!

Jessie…No one looks better than you when ‘pretending’ to flip burgers. LOL

How proud I am of your accomplishments…the end of your internship is certainly something to rave about. Your celebratory party is an event to be envied. You are loved, respected and cared about by some very special people…you must have done something right ;o)

Well, I’m finally back for now and really look forward to your personality shining through in your future posts.

Great question, Sophia! Hmm … while I had a blast during my once-in-a-lifetime China trip, I’m glad to be working toward my future career right now. Also, more time with the dogs! …and Peter…I guess… 😉

I’ve been rotating in the GI oncology unit for the past few weeks so we see a LOT of patients who are unable to eat normal food…yet the only thing we ever seem to offer anyone is ensure. I wonder why some of these other options are offered…

Those supplemental foods are super interesting. I never knew there was such a thing as thickened water. I can’t even imagine what that would be like to drink! Actually, I didn’t even realize there were so many different supplemental foods out there…though I guess that makes sense. I can imagine it would be tough for a kitchen that is serving so many residents with different dietary and medical restrictions to make sure that they get all the nutrients they need. Admirable work! Sounds like you had a great experience there.

Hope the next rotation is going well! I’m really interested to hear about your experience with Subway!

Well I can say this for sure…you manage to make everything look glamorous! And I mean that in all the good sense of the word. I know how much work goes into what you do, or more specifically I can imagine. Following you through your journey has been a wonderful and educational journey! I love that you express such energy and joy, and I know this is what will make you successful. But aside from that will bring so much to so many that really need this kind of light 🙂

Wow this is my first time learning about these Magic Cups. At the hospital where I work, I know they have puddings for people on mechanical soft and puree yogurts, but not those. Wow again 🙂 Thanks Jessie for sharing in words and pics – very informative!

Hi Jessie. I just started to volunteer in a large hospital kitchen hoping that this will help getting accepted to a dietetic internship. I learned a lot from you. I had no idea that today I was serving supplements u mentioned before such as the thickened water and juice for people that have swalloing problems. Thanks a lot!

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